黄色肉芽肿性肾盂肾炎1例

患者女,65岁。反复左侧腰部酸痛1年余,曾在当地医院行超声检查,诊断为左肾结石,口服“排石冲剂”好转。近3个月来有发热,左腰部轻度酸痛,左腰背部出现肿块2周就诊我院。查体:患者一般情况尚可,左侧腰部扣击痛( ),左腰背部可触及5cm×4cm的质硬包块,T37.8℃。实验室检查:血WBC19     

黄色肉芽肿性肾盂肾炎1例

1 病历简介 患者,女,27岁,汉族.因无诱因出现左侧腰部、下腹部胀痛不适半月,加重3天入院.病程中无尿频、尿急、尿痛、血尿,无发热、盗汗,无浮肿,外院诊断为"盆腔炎",予以相应治疗,效果不佳,体重下降3kg.血常规正常.尿常规: WBC 、RBC 3～5/HP.血沉: 64mm/h.肾图检查: 左肾功能重度受损,15min清除率差.     

黄色肉芽肿性肾盂肾炎1例

患者，女，27岁，汉族。因无诱因出现左侧腰部，下腹部胀痛不适半月，加重3天入院。病程中无尿频、尿急、尿痛、血尿、无发势、盗汗、无浮肿，外院诊断为“盆腔炎”、予以相应治疗、效果不佳，体重下降3kg.血常规正常.尿常规：VBC＋、RBC3-5/HP。血沉64mm/h。肾图检查：左肾功能重度受损，     

黄色肉芽肿性肾盂肾炎1例

患者女41岁。反复发热，腰痛，尿频半年入院，近1月症状加重，出现肾绞痛及排尿困难，尿呈乳白色，查体：慢性病容，贫血貌，左腰部饱满、局部红肿，皮温高，触痛明显，心肺及神经系统正常。体温38℃左右。尿液检查：白细胞升高。尿蛋白（ ），有脓细胞，尿培养有革兰氏阴性细菌生长。静脉肾盂造影：左肾不显影。B超：左肾区     

黄色肉芽肿性肾盂肾炎1例

杨某,男,42岁,广东籍,工人。1980年1月7日入院。主诉:反复出现左侧腰痛及血尿8年余。1971年初,无明显诱因突然出现左腰部疼痛,隐痛或钝痛,不放射至他处,数小时后缓解。肉眼血尿,无尿频尿急或尿痛。此后多次发作,间隔时间不等,有时1个月数次,有时4～6个月始发作1次。每次发作数小时或1天。从无绞痛。劳动及跑步后易发生血尿。偶有低热。体重未见明显减轻。1977年在某院作腹部     

黄色肉芽肿性肾盂肾炎1例报告

黄色肉芽肿性肾盂肾炎１例报告安徽省和县中医院放射科陈永青黄色肉芽肿性肾盂肾炎（ＸＧＰＮ），是慢性肾盂肾炎的一种特殊类型、少见的肾脏炎症性疾病，现将我院见到的经手术和病理证实的１例报告如下：患者，男，３６岁。间歇性右季肋部疼痛３月余，食欲欠佳，发热，无...     

黄色肉芽肿性肾盂肾炎1例报告

患者　女 ,2 6岁 ,间断性右腰部钝痛 2个月 ,于 2 0 0 0 -0 8-0 2入院。体检 :腹平软 ,双肾未扪及包块 ,肾区无隆起无压痛 ,右肾区有轻叩击痛。实验室检查 :血尿粪常规正常 ,血沉 5 2ｍｍ·Ｌ-1。Ｂ超检查 :肾中极外缘皮质见约 2 .4ｃｍ× 2 .8ｃｍ×3 .6ｃｍ的异常回声区 ,向表面突起 ,形态不规则 ,边界不清 ,其内回声分布不均匀 ,集合系统轻度受压。ＣＤＦＩ示周边见血流绕行 ,提示右肾实性占位。ＣＴ检查 :平扫示右肾中极外侧肾实质内略低密度影 ,边界不清 ,其外缘略向外隆起 ,右肾盂轻度积水 ,未见结石。增强示右肾中极病变呈不均匀强化…     

黄色肉芽肿性肾盂肾炎

黄色肉芽肿性肾盂肾炎Xanthogranuloma-tous pyelonephritis(XGP)是慢性肾盂肾炎的一种特殊而罕见的类型,近年来报道渐多,因本病易与肿瘤性或其他炎性病变相混淆,术前确诊率甚低,随着超声和CT诊断的进展,才使本病的诊断有所改善。现将有关XGP的临床、病理着重放射学诊断的有关文献综述如下:     

黄色肉芽肿性肾盂肾炎

黄色肉芽肿性肾盂肾炎比较少见,系因肾的非特异性慢性感染所引起。本症常因肾、输尿管结石,或尿路畸形和妊娠等招致排尿困难,多数肾无功能,虽经各种检查也难与肿瘤鉴别。作者指出,腹部平片所见:主要因患侧肾肿大及肾周围炎,致肾轮廓扩大,模糊不清,腰大肌亦显影不清等,有时在输尿管上端可见结石,或在肾实质内显示斑状钙化。肾盂造影多表现患侧肾无功能,少数例造影显示正常。若病变仅局限在某一处时,可显示部分肾盏杯口缺如或压迫移位、延长等占位改变而怀疑肿瘤。逆行性肾盂造影可见输尿管狭窄,肾盂肾盏破坏变形,按此特殊的压迫改变易误认为肿瘤。     

黄色肉芽肿性肾盂肾炎一例

患者女,62岁.右侧腰部胀痛不适1个月,食欲不振,时有尿频.体检:右侧肾区压痛,叩击痛.实验室检查:血常规白细胞10×109/L,中性粒细胞计数0.65,血沉50 mm/h,肝肾功能、肿瘤标志物均未见异常,尿红细胞、白细胞和尿蛋白阳性. CT平扫示右肾外形增大,肾脏下缘见类圆形低密度灶,边界模糊,大小约3.8cm ×5.0 cm,内见囊状低密度区,CT值10～ 24 HU,肾周筋膜增厚(图1),增强扫描动脉期病灶较清晰,病变区局部皮质变薄,边缘实性部分中度强化,CT值约45～ 75 HU,中央可见分隔强化,囊性部分无强化,内壁光滑,无壁结节,肾后筋膜受累增厚(图2);实质期仍见边缘强化,中央低密度无强化,邻近腰大肌略增厚(图3),冠状位可清晰显示病灶范围,右肾形态饱满,肾脏下极见低密度病灶,肾周筋膜内见"絮"状密度增高影(图4).     

气肿性肾盂肾炎1例

患者 男,50岁.因畏寒、高热伴腰背部疼痛7 d入院.查体:T 39℃,P 105次/min,R 45次/min,Bp16 kPa/10 kPa;神志清,左上腹压痛,左肾区叩击痛.实验室检查:血白细胞1.2×109/L,中性粒细胞0.87.尿常规白细胞5～10/HP.既往史:糖尿病多年.     

Pseudotumoral xanthogranulomatous pyelonephritis. Apropos of a case

Xanthogranulomatous pyelonephritis may, rarely, occur as a renal tumour syndrome (simulating mainly a renal cell carcinoma). We report one case. The diagnosis is often difficult (even with surgical findings) and frequently a histological surprise. This points out the importance of identifying it in preoperative staging; the diagnosis may be suggested by the association of chronic pyelonephritis, renal stones and hypovascular renal tumour syndrome without specificity at sonography and CT.     

Computed tomography of xanthogranulomatous pyelonephritis

The computed tomography findings in two cases of xanthogranulomatous pyelonephritis are presented. There was diffuse involvement of the kidney in one case, with correlation with the pathologic specimen and microscopic findings. In the second case there was focal involvement of the kidney. Computed tomography greatly assisted in making a correct preoperative diagnosis and in assessing the degree of extrarenal involvement.     

Sonographic features of xanthogranulomatous pyelonephritis

The ultrasonic findings of three patients with surgically confirmed xanthogranulomatous pyelonephritis are presented. All of the involved kidneys were markedly enlarged, had a large central echogenic area, and demonstrated an increased parenchymal anechoic pattern. The appearance correlated well with the other radiographic and gross pathologic findings. While this appearance was fairly distinctive, it is anticipated that there will be some difficulty in distinguishing this entity from simple hydronephorsis, especially in conjunction with staghorn calculus. It is also anticipated that focal xanthogranulomatous pyelonephritis will have an atypical appearance.     

MR imaging of xanthogranulomatous pyelonephritis

The magnetic resonance (MR) appearance of a case of xanthogranulomatous pyelonephritis is described and compared with CT and surgical findings. Both CT and MR were comparable in displaying the morphology of this uncommon renal abnormality.